中国东北地区遗传性非息肉病性结直肠癌临床病理特点分析  

Clinicopathologic Features Analysis of Patients with Hereditary Nonpolyposis Colorectal Cancer in Northeast Chinese

作　　者：闫一飞[1] 李晓霞[1] 唐元新[1] 李鑫 孙公平[1] 赵萌[1] 孟金[1] 梁高峰[1] 

机构地区：[1]中国医科大学附属第四医院胃肠外科,辽宁沈阳110032

出　　处：《中国普外基础与临床杂志》2013年第2期138-142,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：辽宁省教育厅高等学校科研项目(项目编号:2008781);2011年辽宁省自然科学基金项目(项目编号:201102281)~~

摘　　要：目的分析中国东北地区遗传性非息肉病性结直肠癌(HNPCC)患者的临床病理特点。方法对1982～2011年期间中国医科大学附属第四医院和辽宁省肿瘤医院登记的73例符合Amsterdam标准及28例符合Bethesda指导纲要的101例先证者组成HNPCC组,随机选取同期收治的散发性结直肠癌患者272例组成散发组,回顾性分析、比较2组的临床病理特点。结果 HNPCC组发病年龄≤45岁者24例(23.8%)、肿瘤位于近端结肠31例(30.7%)、多原发癌26例(25.7%)、肠外恶性肿瘤13例(12.9%)、黏液腺癌32例(31.7%)、Ⅰ+Ⅱ期68例(67.3%)、高-中分化70例(69.3%)、有淋巴结转移者33例(32.7%),散发组分别为12例(4.4%)、54例(19.9%)、15例(5.5%)、11例(4.0%)、30例(11.0%)、127例(46.7%)、152例(55.9%)、140例(51.5%),2组比较差异均有统计学意义(P<0.05),但2组间性别比较差异无统计学意义(P>0.05)。同时HNPCC组肠外肿瘤依次是子宫内膜癌3例、膀胱癌3例、乳腺癌2例、脑瘤2例、卵巢癌1例、胃癌1例、肺癌1例。结论中国东北地区HNPCC具有发病年龄早、好发于近侧结肠、多原发癌常见、肠外恶性肿瘤发生率高、黏液腺癌多见、肿瘤分期早、分化程度较好和淋巴结转移少见的特点,临床病理特征仍然是诊断HNPCC患者或可疑患者的首选方法。Objective To analyze the clinical pathological features of patients with hereditary nonpolyposis colorectal cancer （HNPCC） in northeast Chinese. Methods The clinical data of 101 probands （HNPCC group） from 1982 to 2011 in the Fourth Affiliated Hospital of China Medical University and Tumor hospital of Liaoning Province and 272 patients with sporadic colorectal cancer （sporadic CRC group） in the same period were collected. The clinicopathologic features were compared in two groups. Results In the HNPCC group, the age of onset was younger than 45 years old in 24 patients （23.8%）, proximal colon in 31 （30. 7%）, multiple primary carcinomas in 26 （25.7%）, extracolonic carcinoma in 13 （12.9%）, mucinous adenocarcinoma in 32 （31.7%）, phase I and I1 in 68 （67. 3%）, high- middle differentiation in 70 （69.3%）, and lymph node metastasis in 33 （32.7%）, while in the sporadic CRC group were 12 （4. 4%）, 54 （19. 9%）, 15 （5.5%）, 11 （4. 0%）, 30 （11.0%）, 127 （46. 7%）, 152 （55.9%）, and 140 （51.5%）, respectively. There were significant differences between the HNPCC group and the sporadic CRC group （P〈 0. 05）. Meanwhile, extracolonic carcinomas in the HNPCC group were endometrial cancer in 3, bladder cancer in 3, breast cancer in 2, brain tumor in 2, ovarian cancer in 1, gastric cancer in 1, and lung cancer in 1. Conclusions Northeast China HNPCC patients with several particular clinicopathologic features such as early onset, frequent localization in proximal colon, proclivity of synchronous and metachronous tumors, excessive mucinous adenocarcinoma, less poorly differentiated tumors, lymph node metastasis, early stage of tumor, and so on. Therefore, clinicopathologic feature is still a preferred method of diagnosis of HNPCC patients or suspected HNPCC patients.

关 键 词：遗传性非息肉病性结直肠癌 临床病理特点 

分 类 号：R735.3[医药卫生—肿瘤]